Comparison of three preoperative skin preparation techniques in ponies

The purpose of this study was to evaluate the efficacy of 3 preoperative skin preparations (povidone‐iodine [PI] removed with 70% isopropanol, and 4% chlorhexidine gluconate [CG] removed with either 70% isopropanol [CA] or sterile saline solution [CS]) in ponies. Eighteen ponies were randomly assigned to one of the 3 preoperative skin preparation groups. The skin of ponies was aseptically prepared with PI removed with alcohol, or 4% CG removed with either alcohol or sterile saline solution. The antimicrobial efficacy of each skin preparation technique was assessed quantitatively by culturing for surface bacteria with replicating organism detection and counting plates. The percentage of negative cultures, the percentage of cultures with >5 colony forming units (CFU) and the percentage bacterial reduction after the cleansing scrub, the sterile scrub, and the surgical procedures were compared. There was a significant difference between CG and PI in percentage bacterial reduction after the cleansing scrub, but no significant difference at any other time (sterile scrub, post operative skin sampling). In a comparison of the number of negative microbial cultures at each sampling point, there were no significant differences among the 3 skin preparation techniques. There were no significant differences among the treatment groups comparing the number of cultures with a high colony count (>5 CFU) after the cleansing scrub. Skin preparation with CS and PI resulted in significantly fewer cultures with >5 CFU after the sterile scrub than CA. Post operatively, CA had a higher number of samples with >5 CFU than CS and PI. PI removed with alcohol and 4% CS are equally effective in the reduction of skin bacteria after a sterile skin scrub in the operating room; however, CG was more effective in reducing bacterial numbers after the cleansing scrub. The number of cultures with high bacterial counts was greater post operatively, when alcohol was used as a rinse with chlorhexidine. In cases where a sterile scrub is not performed following a cleansing scrub, CG may be a better choice than PI. CA should not be used as a presurgical skin preparation method in ponies.     

Comparison of Two Methods for Presurgical Disinfection of the Equine Hoof

OBJECTIVES: To determine for equine hooves the normal resident aerobic bacterial population and the efficacy of 2 methods of disinfection. Study Design-Measurement of total bacterial, gram-positive bacterial, and gram-negative bacterial surface populations from the frog, sole, and hoof wall after each step of 2 different preoperative surgical disinfection techniques. ANIMALS: Six adult horses. METHODS: Hoof wall, sole, and frog samples were collected for quantitative bacteriology before, during, and after 2 multistep antiseptic preparation techniques: Method A-6-minute scrub with povidone-iodine soap, followed by 24-hour submersion in povidone-iodine solution-soaked cotton; and Method B-initial removal of superficial layer of hoof capsule before completing Method A disinfection procedures. RESULTS: Removal of the superficial hoof layer, application of the povidone iodine scrub, and completion of the povidone-iodine soak all significantly (P < .0008) decreased total bacterial numbers. Method B had significantly lower bacterial counts than method A at each consecutive step. Final total bacterial counts remained greater than 10(5) bacteria per gram of tissue regardless of preparation method. CONCLUSIONS: The hoof surface hosts a broad spectrum of aerobic gram-positive and -negative bacteria, many of which are potential pathogens. Bacterial numbers can be significantly reduced by removal of the superficial hoof surface, by application of a povidone-iodine scrub, and by use of a 24-hour povidone-iodine soak. However, bacterial populations >10(5) g per tissue persist after these disinfection procedures. CLINICAL RELEVANCE: Regardless of the preparation methods used in this study, bacterial populations capable of inducing wound infection remain on the hoof capsule.     

Chlorhexidine Gluconate Versus Chloroxylenol for Preoperative Skin Preparation in Dogs

The efficacy of 3% chloroxylenol (PCMX) or 4% chlorhexidine gluconate (CG) for preoperative skin preparation was assessed in 100 dogs undergoing clean or clean-contaminated surgical procedures. Replication Organism Detection and Counting (RODAC) plates were used to quantify skin bacteria colony forming units (CFU) at the operative site before and after skin preparation and immediately postoperatively. Reduction of CFU after skin preparation and immediately postoperatively was significant for each agent. However, CFU levels were significantly lower in the CG group than in the PCMX group after surgical preparation, regardless of initial CFU numbers. No significant difference in CFU counts was observed between antiseptic groups postoperatively. Within-group comparisons showed PCMX to be significantly less efficacious when the prescrub CFU number was greater than 1,000. Bacterial reduction was similar in the CG group regardless of prescrub CFU levels. The number of negative cultures after skin preparation was significantly greater with CG than with PCMX. Chlorhexidine gluconate also had fewer cultures with heavy bacterial growth (>5 CFUs) after surgical preparation. There was no significant difference between antiseptics in the number of negative cultures or cultures with more than 5 CFUs immediately after surgery. The number of skin reactions and postoperative wound infections that occurred with each technique were similar. Three percent PCMX, as used in this study, was less effective than 4% CG in its immediate antimicrobial activity, however, this difference was not associated with an increased wound infection rate.     

Evaluation of surgical scrub and antiseptic solutions for surgical preparation of canine paws

The purpose of the prospective study reported here was to evaluate surgical preparation of canine paws. Three combinations of surgical scrub solutions and antiseptic solutions were used: (1) 7.5% povidone-iodine scrub/10% povidone-iodine solution; (2) 2% chlorhexidine acetate scrub/2% chlorhexidine diacetate solution; and (3) tincture of green soap/70% isopropyl alcohol. The control was warm (38 to 42 C) tap water. Four microbial colony counts were used to evaluate surgical preparation of 4 paws of 8 dogs. Specimens were obtained from the paws for a baseline microbial flora count. After surgical scrub was performed, additional specimens were obtained for bacteriologic culturing. Antiseptic was applied followed by collection of another specimen for bacteriologic culturing. A final specimen was obtained following a 24-hour period under a sterile occlusive bandage. The 3 scrub solutions and the tap water control resulted in lower colony counts following scrubbing of the paws; however, only the 3 antiseptic solutions resulted in further colony count reduction after their application. Evaluation of residual colony counts isolated from specimens taken after a 24-hour period under a sterile occlusive bandage revealed chlorhexidine and povidone-iodine scrub/antiseptic combinations to be similar in antibacterial activity, with significantly (P less than or equal to 0.05) lower colony counts than those from specimens of paws treated with either the tincture of green soap/isopropyl alcohol combination or the tap water control. The lack of a significant difference between the bacterial counts immediately after surgical preparation with povidone-iodine and chlorhexidine and their respective 24-hour residual counts, indicated no particular advantage to surgical preparation and occlusive bandaging 24 hours prior to surgery.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of an alcohol-based hand rub and water-based chlorhexidine gluconate scrub technique for hand antisepsis prior to elective surgery in horses

This prospective clinical study evaluates the effectiveness of an alcohol-based hand rub (Avagard™) for pre-surgical hand antisepsis in an equine hospital and compares it with traditional scrubbing technique using 4% chlorhexidine gluconate sponges and water. Prior to elective surgery, 3 board-certified surgeons were randomly assigned to hand antisepsis with either technique. Culture samples of each hand were taken at 4 times: before and after neutral soap hand wash, after scrub or rubbing technique, and after surgery. There was no significant difference in mean bacterial colony forming units between scrub and rub techniques over the 3 time periods (P = 0.6), controlling for initial counts. One horse from the scrub group had a skin incision infection following stifle arthroscopy; this was resolved with medical treatment. The alcohol-based hand rub is equivalent in efficacy for pre-surgical hand antisepsis to traditional water-based scrubs in an equine hospital setting.     

Comparative Evaluation of Two Surgical Scrub Preparations in Cattle

One hundred seventeen cattle that had undergone surgery were assigned randomly to two preoperative skin preparation protocols. Group 1 (60 animals) skin preparation was with povidone-iodine soap and isopropyl alcohol, whereas group 2 (57 animals) had skin preparation with chlorhexidine gluconate and isopropyl alcohol. Quantitative microbial culture plates were used to estimate the number of colony forming units (CFUs) before skin preparation (prescrub), after skin preparation (postscrub), after surgery (postoperative), and in room air (environment). A significant decrease in CFU occurred postscrub for both skin preparations ( P <.05). Chlorhexidine and alcohol preparation resulted in significantly fewer CFUs (LSMean ± SE = 2.79 CFU ± 1.74) and a greater percentage reduction in CFUs (98.64%± 2.01) postscrub than povidone and alcohol (LSMean ± SE = 10.27 CFUs ± 1.51, 93.29%± 1.85); ( P <.005). Group 2 had a significantly higher frequency of negative cultures postscrub (49.1%) compared with group 1 (18.3%) ( P <.001). The number of postoperative CFUs were not significantly different between the two treatment groups. Wound infection frequency for clean surgical procedures was not significantly different between the two skin preparation protocols (group 1 = 9.8%, group 2 = 10.7%), however, infection frequency was significantly higher for surgical procedures with a ventral abdominal approach (5 of 14, 35.7%), compared with a flank approach (1 of 41, 2.4%) or other approaches (orthopedic procedures) (1 of 16, 6.3%) ( P <.05). Both skin preparation protocols were effective and safe in decreasing the skin microflora population of cattle before surgery and although preparation with chlorhexidine gluconate and alcohol resulted in less CFUs immediafly postscrub, the frequency of surgical wound infection was similar for both protocols.     

Abstract of Current Literature

Summary: Orthopaedic surgeons in many major arthroplasty centres advocate the use of a prolonged surgical hand-scrub prior to total joint replacement. In this study we evaluated the antimicrobial efficacy of a 5 compared with a 10 min scrub before both long (>90 min) and short (<90 min) operations for total hip arthroplasty. Surgical hand disinfection was performed on one occasion for 5 min and on a second for 10 min by 41 surgeons and theatre nurses using 4% chlorhexidine gluconate as a detergent formulation ('Hibiscrub', ICI Pharmaceuticals). None of the subjects had previously scrubbed on the day of each test. Bacterial colony counts on the fingers were measured using the method described by Rotter (vide infra) before scrubbing, immediately after scrubbing, and at the end of each operation. Our results showed that for arthroplasty procedures lasting less than 90 min (35 operations) a 5 min hand-scrub was equally as effective as one of 10 min. However, following longer procedures (36 operations) colony counts were significantly higher on subjects who had scrubbed for 10 min than on those who only scrubbed for 5 ( P < 0.05, Mann-Whitney U -Test). This study suggests that the practice of a prolonged scrub before total joint replacement does not have a scientific basis and that such a policy should be discontinued where it is still practised. © 1994 The Hospital Infection Society     

Evaluation of arthrocentesis site bacterial flora before and after 4 methods of preparation in horses with and without evidence of skin contamination

OBJECTIVE: To evaluate the effectiveness of four methods of povidone-iodine preparation on skin bacterial flora of arthrocentesis sites, in horses, with and without evidence of skin contamination. STUDY DESIGN: Prospective randomized study. ANIMALS: Twenty-four adult horses. METHODS: Horses were assigned to either the clean or contaminated group based on housing environment and visual evidence of contamination. Using a moist sterile swab, microbial culture samples were obtained from the skin over the distal interphalangeal joints immediately before and after preparation. Each site was aseptically prepared with 1 of 4 povidone-iodine techniques: 10-minutes scrub, 5-minutes scrub, three 30-second scrubs, or commercial one-step iodophor surgical solution. Colony forming units (CFUs) were determined for each sample, 24 hours after inoculation, on blood agar plates. RESULTS: Mean (+/-SD) pre-scrub CFUs/mL was significantly higher in the contaminated group (9588.33+/-1223.65) compared with the clean group (4489.00+/-3842.03) (P<.01). After preparation of the arthrocentesis sites, there were no significant differences in post-scrub CFUs/mL among the 10 minutes (mean clean, 46.00+/-64.36; mean contaminated, 28.67+/-18.04), 5 minutes (mean clean, 84.17+/-109.80; mean contaminated, 40.33+/-44.52), three 30 seconds povidone-iodine scrubs (mean clean, 95.50+/-172.29; mean contaminated, 46.67+/-56.94), or application of a commercial one-step iodophor surgical solution (mean clean, 102.17+/-161.78; mean contaminated 117.67+/-143.78); or between the clean (81.96+/-131.69) and contaminated groups (58.33+/-85.90) (P<.01). CONCLUSIONS: Preparation of the distal interphalangeal joint arthrocentesis site with each of these techniques significantly reduces the bacterial flora to a similar level for arthrocentesis in horses with and without evidence of skin contamination. Clinical Relevance- Aseptic preparation of the skin over the distal interphalangeal joint may be accomplished with any of these techniques.     

Evaluation of Skin Bacterial Flora Before and After Aseptic Preparation of Clipped and Nonclipped Arthrocentesis Sites in Horses

Objective —This study evaluates skin bacterial flora before and after aseptic preparation of clipped and nonclipped arthrocentesis sites in horses. Study Design —The hair over one midcarpal joint and one distal interphalangeal joint on each horse was clipped. The contralateral joint served as the nonclipped comparison. Animals or Sample Population —Twelve adult horses. Methods —A prescrub sample for microbial culture was taken from the dorsal surface of all four joints for each horse. Each site was aseptically prepared with povidone iodine and 70% alcohol, followed by postscrub sampling for microbial culture. Colony forming units (CFUs) were determined for each sample, 24 hours after inoculation of blood agar plates. Results —There was no significant difference (P >.05) in number of postscrub CFUs between clipped and nonclipped skin over the midcarpal or distal interphalangeal joints. Percent bacterial reduction (mean ± SD%) after aseptic preparation differed significantly (P=.02) between clipped (99.8 ±.003%) and nonclipped (96.2 ±.05%) skin at the midcarpal joint, but not at the distal interphalangeal joint (clipped, 98.5 ±.03% and nonclipped, 97.8 ± 0.21%). There was a significant difference (P=.009) in number of prescrub CFUs obtained from clipped and nonclipped skin for the midcarpal joint. There was no significant difference in number of prescrub CFUs between clipped and nonclipped skin at the distal interphalangeal joint. Bacteria isolated from both clipped and nonclipped skin sampled postscrub included Bacillus sp, nonhemolytic Staphylococcus sp, and Micrococcus sp. Conclusions —The presence of hair over the midcarpal and distal interphalangeal joints does not appear to inhibit the ability of antiseptics to effectively reduce bacterial flora to an acceptable level for arthrocentesis. Clinical Relevance —Aseptic preparation of the skin over the midcarpal and distal interphalangeal joints can be accomplished without hair removal in horses.     

市售5种消毒剂对舍饲鸭场的杀菌效果评价

为了解贵州省某舍饲鸭场环境中菌落分布情况以及市售五种常用消毒剂(苯扎溴铵、月苄三甲氯铵、复方戊二醛、戊二醛癸甲溴铵、聚维酮碘)的灭菌效果。通过采集鸭场空气、粪便、垫料、饮水样本进行菌落总数测定;分别配制最小杀菌浓度的苯扎溴铵、月卞三甲氯铵、复方戊二醛及戊二醛癸甲溴铵4种消毒剂,采用雾线、喷洒消毒方式对舍饲鸭场空气、漏缝地板、料槽、蛋框及运输车车轮进行现场消毒;配制最小杀菌浓度的聚维酮碘,采用涂抹方式对鸭蹼部皮肤进行涂抹消毒;最后分别测定鸭场空气、漏缝地板、料槽、蛋框、运输车车轮及鸭蹼样本消毒前后的菌落总数并计算5种消毒剂对细菌的杀菌率。结果显示：舍饲鸭场空气菌落总数为3.79×10⁴ CFU/m³,超出NY/T 388-1999畜禽场环境质量标准规定数值(25000 CFU/m³);粪便菌落总数为2.67×10⁷ CFU/g,超出GB18596-2001畜禽养殖业污染物排放标准规定数值(1.03×10⁶CFU/g);垫料菌落总数为3.7×10⁶CFU/g,超出NY/T1167-2006畜禽场环境质量及卫生控制规范规定的清洁土壤数值(5×10⁴CFU/g);饮水菌落总数为12 CFU/mL,符合GB 5749-2006生活饮用水卫生标准(100CFU/mL)。5种消毒剂对鸭场进行现场消毒试验,复方戊二醛对漏缝地板、蛋框、运输车车轮的细菌杀菌率最高,分别为96.78%、81.31%、87.5%;戊二醛癸甲溴铵对鸭舍空气、料槽的细菌杀菌率最高,分别为34.85%、74.35%;聚维酮碘对鸭蹼部皮肤细菌杀菌率为72.45%;4种消毒剂对漏缝地板、料槽、蛋框、运输车车轮消毒效果良好,对空气的消毒效果不理想;聚维酮碘对鸭蹼部皮肤消毒效果不理想。结果表明：该舍饲鸭场存在大量超过国标菌落总数的安全隐患,通过对该鸭场微生物菌落计数及现场消杀试验,在一定程度将菌落总数控制在了合理范围。研究结果旨在为掌握舍饲鸭场微生物菌落分布情况,制定舍饲鸭场消毒程序以及科学防控养鸭场细菌性疾病提供参考依据。     

Comparison of Three Skin Preparation Techniques Part 2: Clinical Trial in 100 Dogs

The skin of 100 dogs undergoing clean or clean-contaminated surgical procedures was prepared with povidone-iodine (PI) or 4% chlorhexidine gluconate (CG) with saline or 70% isopropyl alcohol rinse. Skin bacteria at the incision site were quantified with Replication Organism Detection and Counting (RODAC) plates immediately before and after skin preparation in the preparation room, in the operating room, and postoperatively. The percentage of bacterial reduction, negative cultures, cultures with more than five colony-forming units, and skin reactions for each technique were calculated for each sample period and analyzed with the analysis of variance and Fischer tests. The percentage of bacterial reduction for all techniques was significant and comparable with results of a previous experimental study. There were no significant differences in percentages of bacterial reduction between PI and the CG techniques for surgical times up to 8 hours. There were fewer negative cultures and more cultures with high bacterial counts with PI than with CG and saline after the cleansing scrub. There were fewer negative cultures after surgery with CG and alcohol than with the other two techniques. Duration of the surgical procedure did not significantly affect the culture results. Significantly more skin reactions occurred with PI. The authors conclude that PI and 4% CG with a saline rinse are equally effective in antimicrobial efficacy under clinical conditions. However, 4% CG with a 70% isopropyl alcohol rinse may be inferior in residual antimicrobial activity.     

Factors affecting bacterial counts during preparation of the hands for aseptic surgery

This study was designed to compare the efficacy of four hand preparation techniques in removing bacteria from the hands preoperatively. The effect of bacteriological swabbing itself on bacterial counts was also investigated. The numbers of bacteria obtained from the dominant and non-dominant hands were also determined. The techniques all used 4 per cent chlorhexidine gluconate, and consisted of rubbing for five minutes with one application of antiseptic; rubbing for five minutes with five applications of antiseptic; rubbing for one minute with one application of antiseptic; and scrubbing with a brush for five minutes with one application of antiseptic. The results showed that the four techniques were equally effective at removing bacteria. There was no significant difference in the bacterial counts obtained from the dominant and non-dominant hands. The wearing of gloves for up to 30 minutes after scrubbing had no effect on the bacterial counts. Swabbing itself significantly reduced the number of bacteria cultured from the hands.     

A prospective comparison between stabilized glutaraldehyde and chlorhexidine gluconate for preoperative skin antisepsis in dogs

OBJECTIVE: To compare the efficacy of 0.3% stabilized glutaraldehyde and alcohol (SG+A), 0.3% SG and water (SG+W), and 4% chlorhexidine gluconate tincture (CG+A), as skin disinfectants in dogs undergoing ovariohysterectomy. STUDY DESIGN: Prospective, blinded clinical study. ANIMALS: One hundred and twenty-one dogs. METHODS: Cutaneous bacterial colony forming units (CFU) from the perioperative site after skin preparation, after antisepsis, and after surgery (incisional and paramedian), were quantified. The influence of high initial bacterial counts (> or =150 CFU) and surgical time on antibacterial efficacy was examined and the proportion of dogs from which Staphylococcus intermedius was cultured, determined. Perioperative skin reactions and wound infections were documented. RESULTS: All 3 antiseptic solutions significantly and equally reduced CFU to all post-antisepsis sampling levels irrespective of surgical duration (mean surgical times 151.6, 136.2, and 149.6 minutes for CG+A, SG+A and SG+W, respectively). Median percentage reductions in CFU ranged between 99.3% and 100%. In dogs with initial high counts and disinfected with CG+A and SG+W, the incisional samples had significantly higher counts than the post-antisepsis samples. In the CG+A and SG+W groups, the proportion of post-surgery samples yielding S. intermedius was significantly higher at the incisional than the paramedian sites. Eight mild cutaneous reactions were recorded in equal proportions for the 3 solutions. There were no recorded infections. CONCLUSIONS: All 3 preparations had an equal ability to reduce and maintain low CFU counts, with minimal cutaneous reactions. CLINICAL RELEVANCE: SG solutions are safe and effective preoperative skin antiseptics for elective clean-contaminated surgical procedures.     

Surgical hand antisepsis in veterinary practice: evaluation of soap scrubs and alcohol based rub techniques

Recent studies have shown that hydro-alcoholic solutions are more efficient than traditional medicated soaps in the pre-surgical hand antisepsis of human surgeons but there is little veterinary literature on the subject. The aim of this study was to compare the efficiency of medicated soaps and a hydro-alcoholic solution prior to surgery using an in-use testing method in a veterinary setting. A preliminary trial was performed that compared the mean log₁₀ number of bacterial colony forming units (CFU) and the reduction factors (RF) between two 5-min hand-scrubbing sessions using different soaps, namely, povidone iodine (PVP) and chlorhexidine gluconate (CHX), and the 1.5-min application of a hydro-alcoholic rub.A clinical in-use trial was then used to compare the hydro-alcoholic rub and CHX in a surgical setting. Sampling was performed using finger printing on agar plates. The hydro-alcoholic rub and CHX had a similar immediate effect, although the sustained effect was significantly better for the hydro-alcoholic rub, while PVP had a significantly lower immediate and sustained effect. The hydro-alcoholic rub showed good efficiency in the clinical trial and could be considered as a useful alternative method for veterinary surgical hand antisepsis.     

A Comparison of Antimicrobial Efficacy and Tissue Reaction of Four Antiseptics on Canine Wounds

Three concentrations of povidone iodine, chlorhexidine, benzalkonium chloride, and a pluronic polyol were tested for antimicrobial efficacy and tissue reaction in wounds inoculated with Staphyloccocus aureus .
Five paired incisions were created on the back of each of 16 dogs in four treatment groups. Five wounds were inoculated with beta-hemolytic, coagulase positive S. aureus (10⁹ organisms); the contralateral wounds were not inoculated. After two hours, three wounds on each side were irrigated with antiseptic in low, medium, or high concentrations; another was irrigated with physiological saline; and one was left untreated. One hundred ml of solution was applied in each instance with a syringe and needle at approximately 8 psi.
Tissue bacteria were quantitated immediately following irrigation. The wounds were sutured with 5/0 monofilament stainless steel and bandaged. After 48 hours, the dogs were euthanized and signs of wound infection were recorded. Wound bacteria were quantitated again, and sections of the wounds were removed for examination by light microscopy.
Antiseptics were significantly effective (p < 0.01) in reducing the bacterial population in contaminated wounds when compared to control wounds on the same dog. High antiseptic concentrations were more effective than low concentrations. At 48 hours, the bacterial population was significantly lower in wounds treated with chlorhexidine or benzalkonium chloride compared with povidone iodine or pluronic polyol. The antiseptics caused no significant difference (p < 0.01) in tissue reaction in noninoculated wounds. Chlorhexidine (0.5 or 1.0%) was the most effective antiseptic under the conditions used.     

In vitro algaecide effect of disinfectants on Prototheca zopfii genotypes 1 and 2

Bovine mastitis due to Prototheca zopfii leads to reduced milk production and is difficult to cure. Therefore, prevention is the best approach and this is best achieved through the use of effective disinfectants. The aim of this study was to evaluate the in vitro algaecide efficacy of conventional disinfectants against strains of P. zopfii genotype 1 and 2. The minimal algaecide concentration (MAC) of alkyldiaminoethylglycine hydrochloride, chlorhexidine, dioxide chlorine, povidone iodine and sodium hypochlorous acid against 10 isolates and the type strain (SAG2063(T)) of P. zopfii genotype 1 as well as 10 isolates and the type strain (SAG2021(T)) of P. zopfii genotype 2 were examined using the micro dilution method. This in vitro study indicated that alkyldiaminoethylglycine hydrochloride, chlorhexidine, povidone iodine and sodium hypochlorous acid, but not dioxide chlorine, are effective against both genotypes of P. zopfii.     

Presurgical hand antisepsis: concepts and current habits of veterinary surgeons

Objective: To assess current habits for surgical hand preparation among veterinary surgical specialists and to compare data with current guidelines for hand asepsis techniques. Study design: Survey of veterinary surgical specialists. Sample Population: Diplomates of the American (ACVS) and European Colleges of Veterinary Surgeons (ECVS). Methods: An internet‐based survey of hand preparation methods before surgical procedures was conducted of 1300 listed ACVS and ECVS Diplomates. Results: A 42.6% response rate was obtained. Approximately, 80% of respondents use disinfecting soaps as a primary method for hand antisepsis. Of those, 81% use chlorhexidine‐based scrubs and 7% use a neutral soap followed by a hydroalcoholic solution. Conclusions: Contrary to current recommendations of the World Health Organization and scientific evidence supporting use of hydro‐alcoholic rubs for presurgical hand preparation, veterinary surgical specialists still use surgical scrub solutions containing disinfecting soaps.     

Wound Healing in Rainbow Trout following Surgical Site Preparation with a Povidone–Iodine Antiseptic

Abstract

We investigated the effects of preparing surgical incision sites with a topical antiseptic on wound healing and hematological response in rainbow trout Oncorhynchus mykiss. A povidone–iodine solution was applied both pre- and postsurgery to the incision sites on treated fish. Three-centimeter incisions in both treated (N = 9) and control (nontreated, N = 9) fish were closed with four nonabsorbable sutures sewn in a simple interrupted pattern. During the 42-d period of wound healing, there were no statistically significant changes in total erythrocyte counts (1.28 × 10⁶/mm³ ± 0.05 SE), in percentage of dividing erythrocytes (0.76% ± 0.07 SE), or in differential leukocyte counts. Postmortem, pathogenic bacterial infections in the kidney or spleen were not detected in any of the fish. There was no histological difference between control and treated incisions to show either beneficial or adverse tissue reactions to the topical antiseptic treatments. Blinded histological analysis revealed both treated and untreated incision sites healed within 42 d at the same rate. Therefore, preparation of the incision sites with a povidone–iodine antiseptic did not improve wound healing nor alter healing rate in rainbow trout under the conditions of this study.     

Surgical Wound Infection Rates in Dogs and Cats Data from a Teaching Hospital

Two thousand sixty-three surgical procedures were performed on 1992 patients (1715 dogs and 277 cats). In a retrospective analysis, the procedures were categorized according to the expected degree of wound contamination, and corresponding wound infection rates were determined. The number of procedures in each category and the percent that became infected were as follows: clean (1100, 2.5%), clean-contaminated (554, 4.5%), contaminated (172, 5.8%), and dirty (237, 18.1%). The administration of antibiotics significantly reduced the frequency of wound infection in clean surgical procedures performed by senior veterinary students (p less than 0.05), but not in clean elective procedures performed by faculty or resident surgeons that required 90 minutes or less to complete. There was a significant correlation between elevation of rectal temperature postoperatively and increased duration of the surgical procedure. However, the rectal temperature measured the day after surgery was not an accurate predictor of wound infection.     

Efficacy of a surgical scrub including 2% chlorhexidine acetate for canine superficial pyoderma

The clinical efficacy of a surgical scrub containing 2% chlorhexidine acetate (2CA; Nolvasan^® Surgical Scrub; Fort Dodge Animal Health, USA) was evaluated for the topical management of canine superficial pyoderma. The first study was a randomized, double‐blind, controlled trial. The control was a shampoo containing 4% chlorhexidine gluconate (4CG; Skin Clinic Shampoo; CHD MEDICS, Goyang, Korea). Ten dogs with symmetrical lesions of canine superficial pyoderma were allocated to receive either 2CA or the control shampoo applied to either side of the body twice weekly for 1 week. Both the owners and the investigators subjectively scored skin lesions including pruritus, erythema, crusted papules and scales on a scale of 0–3. The 2CA and 4CG resulted in almost the same degree of improvement of skin lesions, and there were no significant differences between the two groups. The second study was an open trial of 2CA monotherapy in eight dogs with cefalexin‐resistant Staphylococcus intermedius group‐associated superficial pyoderma. The 2CA monotherapy was applied every 2 days for 2 weeks. Five dogs improved with 2CA monotherapy, one partially improved and two did not. No adverse reactions were seen in either trial. This suggests that a 2CA surgical scrub could be a useful and safe topical adjunct therapy for dogs with superficial pyoderma involving cefalexin‐resistant Staphylococcus intermedius group.